Mr. Speaker, I rise today in the House to make a statement on the Government of Canada's position following the adoption yesterday in Alberta of bill 11, legislation that provides for the expansion of the role of private for profit facilities in delivering surgical services in that province.

Let me first put this issue into a broader context. We all know that the time has come to strengthen and renew Canadian medicare. Indeed, governments across the country accept that the status quo is no longer an option. The Government of Canada recognizes that it must do its part and is prepared to commit to long term stable increases in funding to support a common plan and set of priorities.

The improvements and the changes required can and must occur within the context of our public medicare system. The principles of the Canada Health Act are broad and flexible enough to allow for innovation while building on the strengths of our single payer system. It is clear from the reaction of the majority of Albertans to bill 11 that they strongly agree. They know that we need not imperil our principles in order to improve our practices.

For our part, the Government of Canada, has repeatedly expressed the view that bill 11 is not the direction in which we should be heading to strengthen our publicly funded health care system. We have grave reservations about investing public funds in private for profit facilities, particularly where they offer services that involve overnight stays.

I would like to reiterate for the House the concerns that I have outlined to the Government of Alberta and the steps we plan to take to safeguard the interests of Albertans, and all Canadians, with regard to the principles of the Canada Health Act.

First, we have already informed the Government of Alberta that surgical facilities as defined in bill 11 will be considered for our purposes to be hospitals within the meaning of that term in the Canada Health Act. The practical effect of what that means is that any charges to patients or insured health services in these facilities will be considered a violation of the Canada Health Act. I want to make it clear that should that happen I have the power required to fulfil my responsibilities as Minister of Health and enforce the Canada Health Act in that regard.

On a second matter, we suggested some weeks ago to the Government of Alberta that bill 11 be amended to reflect legislation in Saskatchewan and Ontario that prohibits charging for enhanced services in private for profit facilities. To permit for profit facilities to sell enhanced services in combination with insured services may create a circumstance that represents a serious concern in relation to the principle of accessibility in our health care system.

The Government of Alberta has chosen not to make such an amendment. We are therefore serving notice today that we will monitor closely what may happen on the ground in private for profit facilities permitted under Bill 11 to ensure that queue jumping and other accessibility issues do not arise.

We are not singling out Alberta, but we will ensure compliance with the Canada Health Act in Alberta as in any other province. If violations of the Canada Health Act occur we have the authority to act and we will do so.

Let me say a word about the way in which the Government of Canada is permitted to enforce the principles of the Canada Health Act. We cannot withhold funds based only on a suspicion that practices might develop under the bill that might contravene the Canada Health Act.

The process to be followed is clearly outlined in the CHA. A case must be built; concrete evidence must be collected and shared with the province in question; efforts must be made to resolve the conflict and, should that fail, then funds will be withheld.

We will continue to work openly and transparently with all provinces, in accordance with our social union framework commitments.

On the subject of Canada Health Act compliance, the auditor general has recently expressed his view that Health Canada does not have the capacity to enforce its responsibilities under that act. I am therefore immediately allocating an additional $4 million to an existing budget of $1.5 million annually to monitor, assess and ensure compliance with the Canada Health Act.

As a result, Health Canada will have increased staff across the country to monitor compliance with the act's principles and conditions and to develop a capacity to investigate potential non-compliance issues and to assess the facts.

The message of the Government of Canada today is clear. We intend to meet our responsibilities to protect public medicare in this country. The health care system does not belong to governments or to political parties, it belongs to Canadians. Parliament has given us the tools to enforce the Canada Health Act. Canadians expect us to use those tools when necessary to protect our principles. I will make certain that those principles are respected in Alberta and throughout the country.

Let me close by saying that while we are prepared to act if there are violations, I also hope that we do not reach that point.

I began by saying that the time has come to renew and strengthen public medicare in Canada. That is a process that will require collaboration and co-operation among all governments. In the last analysis, we will not preserve medicare simply by enforcing rules. We will do so by renewing our common commitment toward its principles and objectives. That involves, among other things, the proper level of funding, including appropriate funding from the Government of Canada.

I will devote my efforts in the weeks and months ahead toward building a constructive working relationship with Alberta and other provinces focusing on the creativity and innovation that will be required if we are to preserve for all Canadians what they cherish most, a strong public health care system.

Mr. Speaker, I listened with interest to the statement by the health minister. His rhetoric was excellent. He talked about co-operation. He talked about protecting the Canada Health Act. He has made the statement over and over that the status quo is not good enough. I would like to go over a few of the objective facts which I do not think the minister mentioned. He probably would not like them mentioned in this forum.

In 1993 health and education transfers to the provinces were $18.8 billion. That was when the Liberals took office. Today in 2000 they are $15.5 billion, and they went down to as low as $12.5 billion. Most important are statistics regarding per capita spending under health, which under the federal Liberals has dropped. That comes directly from the health institute. We have dropped from number two in health care spending in the world. We are now number five and dropping. Those statistics are not up to date. They are about three years old.

The private share of health in Canada when the Liberals took power was 27%. It is now over 30%. Fewer procedures are covered under medicare today compared to 1993. Public confidence in health care today is at the lowest level in Canadian history. The final and probably the worst issue is that the waiting lists in Canada are longer today than they have ever been.

I am optimistic about health care because I do not believe Canadians will let health care be lost. Even some high profile Liberals have come out lately and said that the status quo was not enough. They are not willing to leave it at a statement like that. I do not agree with this, but Tom Kent said that user fees might be necessary in Canada.

What is the Liberal response to the bill in Alberta, a place where I practised medicine for 25 years? More health police, that is the commitment. More threats, that is the commitment. More protection of the system instead of the patient.

I should like to spend just a brief minute on bill 11. It is a very tentative step toward innovation, a very modest step. I believe that provinces which try to innovate, try to improve waiting lines, and try to bring in fresh new thinking should be rewarded rather than threatened.

What would I do if I were the health minister in this case? I would say to Alberta, if I did not agree with bill 11, that it has two years to prove that the bill will do something. Alberta believes that this bill will shorten waiting lines. Can we measure the waiting lines today and can we measure them in two years? If bill 11 reduces waiting lines in Alberta, I would reward the province. I would give it a big pat on the back.

The Liberal government will not be judged by its rhetoric. It will be judged by its actions. What should the government do? I should like to be constructive in this regard. Funding should not be covered in a big Canada health and social transfer, but federal funding should be specific for health so that every Canadian could judge whether or not the funding was appropriate. There should be a growth factor for inflation and for population growth.

I said before that we should reward provinces that reduce waits. Would I have health police to monitor how Alberta is doing? No, I would let the citizens of Alberta decide whether or not their provincial government was looking after medicare in the way they felt was appropriate.

I direct this comment to the health minister. I would beg the health minister to put the patient first rather than the system. If he will do that, medicare will survive.

Mr. Speaker, I wish to begin by stating that the intervention by the Minister of Health is, at the very least, paradoxical.

Here we have a minister proposing the addition of $4 million extra to hire more staff for inspection and monitoring purposes relating to the enforcement of the Canada Health Act. The five principles set out in that act include universality, portability, and public funding, as we are entitled to expect for public services.

At the same time, the federal government is not fulfilling its part of the contract as far as health is concerned. Take Quebec for example. As we speak, the federal government contributes a little over 20 cents, 22 to be exact, of every dollar invested in health.

Yet when the public plans were set up in the 1960s, the federal government committed to a 50% contribution. On a number of occasions, all provincial premiers have demanded that this government re-establish transfer payments to their 1993-94 level.

As a party, we do not subscribe to the reflex of privatization of certain provinces. Thank heavens, the Government of Quebec is very far removed from such a desire for privatization. It is our profound belief that governments have the responsibility to use public funds and public resources to put into place a generous, universal, accessible health system, one which meets the needs of our fellow citizens, particularly in today's context, with not just the elderly but also another group more advanced in age, the old elderly, and with people wanting to remain in their natural communities as long as possible.

We are forced to see a connection between the fact that this government has cut transfer payments to the provinces and the fact that that the provinces did not always get their share of the resources they were entitled to expect from it in order to keep the system viable.

How can the minister be surprised at this point? How can the minister play wounded innocent? How can he be so hypocritical today as to oppose this in the role of defender of the public health system, when he himself is not fulfilling his part of the contract?

I say to the minister that we are prepared to go along with him in certain instances, such as the case of smoking, where we do not want young people to be the primary victims of inadequate information when their health is concerned. But we will go after this minister to get him to assume his responsibilities and reinstate the transfer payments at their 1993-94 level.

It is not surprising today, since the federal government has failed to honour its part of the contract, that certain provinces are tempted to privatize. We might have wished that, in addition to announcing the increase in staff for inspection work, what we might call the health police, the government would assume its share of the responsibility.

In terms of transfer payments, for Quebec alone, $1.4 billion has been cut in health care. If the Minister of Health is serious and concerned about the integrity of the public health care systems, his first responsibility is to rise in this House and say that he will lead the battle in Cabinet to have the transfer payments returned and that he will deliver the money he owes the provinces.

For Quebec alone, the figure of $500 million is at issue annually, for health care alone. That is the equivalent of Quebec's entire budget for home care, and about half the budget for the CLSCs.

If the minister wants to have some credibility, if he wants opposition parties to work with him, if he wants to be a respected voice in the health sector, his number one responsibility is to support the provinces, which are urging him to be a strong voice within cabinet and demand that transfer payments be restored. That is the minister's primary responsibility, and I hope that he will work on that in the coming days.

It is all too easy to be concerned about what is going on in the provinces. It is all too easy to want to encroach.

The minister sent a letter to the Standing Committee on Health asking us to set up a national mental health strategy. What business does the federal government have with mental health? Read the letter sent to us by the minister. He wants a national mental health strategy. But this area does not come under his jurisdiction. Let us not be hypocrites.

It is all too easy to be concerned about the provinces violating the law, considering that in 1966 the government itself, as a partner, pledged to contribute 50% to health care programs, but does not do so. It is all too easy to be concerned like that.

I do not expect this minister to be a tormented soul, but like all my Bloc Quebecois colleagues and, I am sure, all the opposition members, I do expect him to loosen the purse strings, resist the temptation to set up new national programs, avoid any future encroachment and assume his responsibilities, which are to restore health transfer payments to their 1993-94 level.

Mr. Speaker, it is with a profound sense of sadness that I rise today to address the remarks of the Minister of Health. It is ironic and disappointing in the extreme that I am responding to remarks.

Since bill 11 was unveiled last fall on November 17, to be exact, the Minister of Health has offered nothing but remarks on how the bill is bad policy, remarks on how he wanted Ralph Klein to withdraw the bill, and remarks on how important it is to protect our public accessible health care system. Today, as the biggest threat ever to medicare has now passed into law, what is the government's response? More remarks.

On November 17, 1999, the NDP called for action. The minister's response at the time was “The proposals that came from Alberta arrived today. We are looking at them”. On December 13, 1999, the NDP called for action. The minister's response was “We will react to it as soon as we have completed our examination”. On March 2 the NDP called for action. The minister's response was “We are awaiting tabling of the legislation later today”. On March 15 the NDP called for action. The minister's response was “We have yet to see the regulations”. Again on Tuesday the NDP called for action. The minister's response was “We will monitor what happens”.

Today is an historic day, a sad day, a shameful day, a day when Canada's health minister has said that a parallel for profit health care system can proceed.

It is a day when the Minister of Health has said that a hospital can exist and operate on a for-profit basis.

He has said that our country is now one where the wealthy can get health care ahead of the less wealthy.

He said that the content of bill 11 is not bad, not a problem, but that there may be dangers in its implementation. This is the minister's ticket into the history books because according to his own words private for profit hospitals are not in and of themselves bad.

Let us examine the facts. For months the minister said today would be the day of action. Yet all we have is more talk, more remarks about how he might act tomorrow. There is not a word on his secret 12 point privatization deal with Alberta. There is not a word on NAFTA's implication. There is not a word on his own $24.7 billion in federal cuts that Ralph Klein uses as an excuse. There is not one word on the fact that Ralph Klein introduced bill 11 just two days after the federal Liberal budget gave a mere two cents for health care for every dollar in tax cuts.

It is clear the minister has dropped the ball, as my kids would say, big time. We welcome today's long overdue announcement that real enforcement of the Canada Health Act will finally begin, but the fact is that on November 30, 1999, the NDP called for enforcement of the Canada Health Act. The fact that the government is finally paying for health care monitoring is not a response to bill 11, because a real response to bill 11 would take action. It would not just speak about the possibility of taking action at some future date. A real response would be for the minister not to be outsmarted by Ralph Klein. If it is the minister's opinion that bill 11 complies with the Canada Health Act, then amend the Canada Health Act to give it the teeth needed to protect medicare.

On April 12 the minister said that bill 11 imperils the principle of accessibility. I would argue that it kills the principles of accessibility but let us stick with the minister's words. If it imperils medicare's foundation, then for heaven's sake, take action. If the minister does not think he can take action, then change the Canada Health Act to allow it.

This government has already amended the Canada Health Act. In 1995, section 6 was removed in order to allow greater privatization. It could be amended again so as to prevent greater privatization.

Instead the minister chooses to posture. It is posture because the NDP raised existing violations of the Canada Health Act both in Calgary and Montreal recently and the minister chose to do nothing. It is posture because four years ago the last time a Liberal health minister went to Alberta to supposedly save medicare, we got a secret deal facilitating two tier and privatization. It was a secret deal that paved the way for bill 11 today. If the minister had wanted to act, he could have cancelled that secret deal.

It is astounding that the minister still has not tabled and today did not even mention a single legal opinion on the NAFTA implications of bill 11. He announced a medicare police force but he ignored the fact that if NAFTA takes effect, the lawmaker will not be him, the lawmaker will be an unelected, unaccountable trade tribunal.

On November 26, 1999 the minister said “Bill 11 may run afoul of provisions of NAFTA”. On April 12 the minister actually boasted about raising with Alberta a definite problem with NAFTA. On April 13 the minister said the situation was so serious that two other ministries and their experts were studying the NAFTA implications. We do not have these studies. The minister now says that the Canadian right to regulate and protect our health care system is not affected by NAFTA.

Where are the studies to support this brave statement? Where are they?

Barry Appleton says that bill 11 loses our NAFTA exemption. His study is public. The last time the Liberals said he was wrong, they lost it at NAFTA. If the minister is saying Appleton is wrong and he is right, where are the studies? Show us the studies. If Appleton is right and the minister is wrong, he can have a million cops to police medicare but a NAFTA tribunal can overrule them all.

Today's statement by the minister does nothing to stop the massive threat that bill 11 presents. It does nothing to stop Mike Harris from doing his own bill 11, nothing to stop John Hamm from doing the same, and nothing to stop Bernard Lord. Ralph Klein's bill sadly is now law; it is unchanged, it will affect Albertans and thanks to this minister, it will affect us all. The minister's legacy and the Prime Minister's legacy will be the destruction of medicare.

On behalf of the thousands of Albertans who bravely fought Ralph Klein, I condemn the minister's cowardice. On behalf of millions of Canadians, we will not forget.

Mr. Speaker, there is a crisis in health care and the blame for that can be laid right at the door of the government and specifically the health minister. The government has had seven years to do something, seven years with not one single idea. If that is not frightening in itself, just consider this. If the Liberals stay in power until 2004, and hopefully they will not, but if they do, the Liberal government will have surgically removed $30 billion from health care alone.

Given the fact that Ralph Klein and other premiers have had to scramble, the question would be why not? They have had no choice. Funding has been drastically reduced to the point where the provinces are going to have to make up the shortfall. The government has created this crisis.

The approach by the government has been ad hoc, making it up as it goes along. The Liberal government has never had a plan and it has been going on seven years without a plan. The health minister should consider calling a national symposium on health care with all of the stakeholders in one room. It should include health care professionals, caregivers and doctors along with the first ministers, the health ministers and most important, the Prime Minister. Why has that not been done? The government has conveniently blamed the provinces for the past seven years. That approach is not going to work. It is going to cost the Liberal Party its power. Canadians are not going to take any more. It reminds me of the famous phrase, no ideas, no votes. The government is devoid of ideas in the health care field.

The federal government has violated the five principles of the Canada Health Act not to mention what the provincial governments have done. Just to remind the health minister, the five principles are a system that is accessible, universal, comprehensive, portable and publicly funded. If the system is not publicly funded as it has to be by the federal government, what choice do the provinces have? The answer is simply no choice.

I want to read into the record a couple of questions that my leader, Joe Clark, had on this issue. These drive the point home quite well. Why does the Liberal government not restore the health care funding that was taken away without consultation right now? Why does the Liberal government not restore the stability of funding so that hospitals and health care professionals and provinces can plan with some certainty?

Our party and our leader suggest that we need a sixth principle in health care which would be stable, long term, sustainable funding so the provinces know where they are going and what they can do. Making it up as we go along is simply not good enough. We are asking for leadership on this issue. We have had absolutely no leadership from the minister or the government.

I read the minister's statement. What has he come up with? A paltry $4 million for what is now called health care police. The government is going to spend $4 million to peek around the corners, lift up the carpets and find out what is going on within the hospital system. Is that the best the government can do after seven years? It is not good enough. I am suggesting that the government immediately call together all the principal stakeholders in the health care field and get to work to come up with a long term sustainable plan.

The government has basically taken $30 billion out of the system and downloaded it on the backs of the taxpayer. At the end of the day where does that money go? What is done with it? Where is the shortfall? Is it ever used? Does it show up? Of course it does. The Liberals are bragging about balancing the books, fiscal responsibility. It is fiscal responsibility on the backs of the taxpayers. The government has no plan.

The U.S. system scares the heck out of Canadians and that system is the way our system is headed if the Liberals stay in power. The U.S. system is fueled by two things: litigation and insurance companies. We do not want to see that happen here. Unfortunately if the minister stays in his present job and the Liberal government stays in power, that is exactly where we are headed.

The provinces are scrambling to make up the difference. Examine everything that has happened in Alberta and all the other provinces. Incidentally, Alberta is not alone in this. In my home province of New Brunswick, the private sector accounts for about 35% of all spending. In Alberta it is slightly less than that. The problem is not isolated in Alberta alone. It affects all provinces and jurisdictions simply because the federal government has refused to act on the number one issue or the number one challenge in the minds of all Canadians. Young or old, we are all suggesting that the federal government can do more.

The underlying theme to our position is let us see the plan. The Liberals have been here for seven years. The backbenchers love to yak, but they are devoid of ideas themselves. They are nothing more than lapdogs to the minister who has consistently done nothing about this problem. If they have something constructive to say, then they should get up on their hind legs and let us hear them. They have not done a single thing. They are nothing more than the peanut gallery. They are trained seals who prop up the health minister whenever he needs it. Today is no exception. Let them come across and we will give them some ideas. Let them be brave enough to stand up on their hind legs and suggest what some of those ideas might be.

We want leadership on this issue. Canadians are demanding leadership. There has been no leadership. No ideas, no votes. The jury is out. The Canadian public will decide whether the Liberals have handled this file properly or not. I suggest they have not.

Mr. Speaker, I rise on a point of order. Would there be a disposition in the House to return to tabling of documents to allow the Parliamentary Secretary to the Minister for International Trade to table a government document?

Mr. Speaker, I have the honour and duty to present in both official languages the second report of the Standing Committee on Transport.

Pursuant to its order of reference of Tuesday, February 29, 2000, your committee has considered Bill C-26, an act to amend the Canada Transportation Act, the Competition Act, the Competition Tribunal Act and the Air Canada Public Participation Act and to amend another act in consequence, and reports Bill C-26 with amendments.

I would be remiss if I did not recognize the hard work of certain people in the formulation of Bill C-26 and its amendments. First, I would like to thank Guyanne Desforges, the clerk of the Standing Committee on Transport and to John Christopher and June Dewetering our researchers from the Library of Parliament. I would also like to thank the Minister of Transport, his staff and the officials of the Ministry of Transport whose participation and co-operation with the committee are greatly appreciated. Finally, I would like to acknowledge the efforts of my colleagues from all parties in the House, the members of the Standing Committee on Transport.

Mr. Speaker, it is a pleasure to stand on behalf of my constituents today to present two petitions pursuant to Standing Order 36.

The first petition is from a group of citizens in Macklin, which is on the west side of my riding. They are quite concerned about the nuclear capabilities of a lot of countries that really do not seem to have the strength to handle that type of power in the world. They, therefore, ask the Canadian government to look into the situation.

Mr. Speaker, the second petition concerns the supremacy of God. The petitioners would like the supremacy of God to remain in the statutes of Canada. They are very concerned that the government is softening its stance in that regard.

Mr. Speaker, I am pleased to present a petition not signed by 100 Canadians, not signed by 3,000 Canadians, but signed by 6,000 Canadians. The petitioners call for the release of the post-1901 census records after a reasonable period of time has passed.

The census records are a tremendous resource for more than 7.5 million citizens who are currently engaged in family research. The post-1901 census records contain facts about the everyday lives of average Canadians. They tell about Canada's collective past, present and future. These records are not only the reference point for descendants of many immigrants wishing to trace their heritage, they are also an essential tool for genealogists everywhere.

Therefore, the petitioners ask parliament to amend the Statistics Act to allow for the public release of the post-1901 census records.

Mr. Speaker, I am happy to present a petition on behalf of hundreds of people from the Lakeland constituency, mostly from the Cold Lake area.

The petitioners are extremely upset with the inaction of the government regarding child pornography. They ask that parliament deal with the issue of pornography by using section 33 of the charter of rights and freedoms to invoke the notwithstanding clause to override the B.C. court decision which legalized pornography.

Mr. Speaker, I have about 750 signatures of individuals who call to the attention of parliament the rights of freedom of religion and freedom of conscience. They ask for protection for health care workers, and those seeking training for careers in the health care sector, who have been stripped of those rights.

They call upon parliament to enact legislation against such violations of conscience rights by administrators in medical facilities and educational institutions.

Mr. Speaker, the second petition is related to Bill C-23. These citizens of Canada lament its passage, but it is still not too late as it is now being studied by the Senate.

The petitioners want us to affirm the opposite sex definition of marriage in legislation and ensure that marriage is recognized as having been a unique institution of great good to society historically. They want that to be recognized by the Parliament of Canada to the good of our nation.

Which of the groups the Minister of Citizenship and Immigration consulted with during the period from February 27, 1998, through March 11, 1998 inclusive regarding the legislative review ministerial consultations, have received government issued grants and/or subsidies, and of those: ( a ) what was the total grant/subsidy; ( b ) the reason for the grant/subsidy; and ( c ) which government department issued the grant/subsidy?

With regard to each of the groups consulted by the Minister of Citizenship and Immigration during the period from February 27, 1998 through to March 11, 1998, the following received contribution funds (Citizenship and Immigration Canada, CIC, does not provide grants or subsidies to organizations) in fiscal year 1997-98* under one or more of CIC's settlement programs or services: Immigrant settlement and Adaptation Program, ISAP, which provides a variety of settlement services to immigrants, such as orientation, community information, interpretation/translation, para-professional counseling, employment-related services; Language Instruction for Newcomers to Canada, LINC, which provides training in one of Canada's official languages to adult immigrants; the Host Program which matches immigrants to Canadians who help them with various aspects of life in Canada; and Reception House, RH, which provides temporary accomodation to government assisted refugees.

Organizations in Quebec do not receive contribution funds from CIC. As per the Canada-Quebec accord, the province of Quebec assumes responsibility for providing settlement services.

*Contribution agreements are signed for a total amount which covers the duration of the agreement. As the period of time for which the funding information was requested does not coincide with the periods covered by the contribution agreements, we are unable to give dollar figures for the exact period requested by the hon. member.